India has a population of one billion, around half of whom are adults in the sexually active age group. The first AIDS case in India was detected in 1986, and since then HIV infection has been reported in all States and Union Territories.

The spread of HIV in India has been diverse, with much of India having a low rate of infection and the epidemic being most extreme in the southern half of the country and in the far north-east. The highest HIV prevalence rates are found in Maharashtra in the west; Andhra Pradesh and Karnataka in the south; and Manipur and Nagaland in the north-east.

As of May 2005, 92% of all nationally reported AIDS cases have been found in 10 of the 38 States Union Territories. The greatest numbers were in Maharashtra and Gujarat in the west; Tamil Nadu and Andhra Pradesh in the south; and Manipur in the north-east.

In the southern States, the infections are mostly due to heterosexual contact, while infections are mainly found amongst injecting drug users in Manipur and Nagaland.

Estimated numbers of adults and children living with HIV/AIDS, end of 2003

Group

Living with HIV/AIDS

Adults

5,000,000

Women

1,900,000

Children

120,000

Total

5,100,000

Adult HIV prevalence estimate

0.9%

These are UNAIDS/WHO estimates. Adults are defined as men and women aged 15 to 49. These estimates include all those with HIV infection, whether or not they have developed symptoms of AIDS.

The Indian National AIDS Control Organization (NACO) estimates that 5.134 million people were living with HIV in 2004. This represents a slight increase from the 2003 estimate, and a substantial increase from 4.58 million in 2002. Only South Africa has more people living with HIV.

AIDS data, end of May 2005

Gender

Cumulative AIDS cases

Male

77,457

Female

31,892

Total

109,349

The statistics for AIDS cases may be a poor guide to the severity of the epidemic, as in many situations a patient will die without HIV having been diagnosed, and with the cause of death attributed to an opportunistic infection, such as tuberculosis or PCP.